Use and de-implementation of fecal occult blood tests in the acute care setting: a systematic review and meta-analysis
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View abstract on PubMed
Summary
This summary is machine-generated.Fecal occult blood testing (FOBT) in acute care settings offers no diagnostic benefit and increases workload. De-implementation strategies are essential for discontinuing this low-value, tradition-based practice.
Area Of Science
- Medical Practice
- Health Services Research
- Gastroenterology
Background
- Fecal occult blood testing (FOBT) is valuable for colorectal cancer screening in outpatient settings.
- However, its utility in acute care settings for diagnostics is questionable, with consistent indications for discontinuation.
- FOBT in acute care is often a tradition-based practice rather than evidence-based.
Purpose Of The Study
- To determine methods for de-implementing FOBT in acute care.
- To summarize reasons and contraindications for inappropriate FOBT use in acute care.
- To critically appraise low-value, tradition-based practices in healthcare.
Main Methods
- Systematic review and meta-analysis of English language prospective and retrospective studies on FOBT use or de-implementation in acute care.
- Included studies published in peer-reviewed journals.
- Quality assessed using Critical Appraisals Skills Programme criteria.
Main Results
- 22 articles met inclusion criteria, evaluating FOBT use or de-implementation in acute care.
- FOBT positivity was reported in 20 studies; results were inconsequential to endoscopy decisions in 32% of cases.
- Limited documentation of de-implementation strategies was found; only four studies described administrative elimination of FOBT orders.
Conclusions
- FOBT use in acute care settings increases workload and/or cost without diagnostic benefit.
- De-implementation of FOBT in acute care is supported by all included studies.
- Critical appraisal of low-value practices is essential for effective de-implementation strategies.
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